Process-Aware EHR Workflow Management Systems: Essentials, History, Healthcare (Written In 2004!)

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In 2003 and 2004, thirteen years ago, I wrote a series of white papers, and presented them at the now defunct TEPR (Towards an Electronic Patient Record) and 2005 HIMSS conference in Dallas. In that series I laid out a dramatically different EHR architecture. It was workflow-centric, whereas todays EHRs are data-centric. I was remarkably prescient. However, it’s taken more than a decade so see much of what I predicted to finally begin to come true. Every year, since 2011, I search every HIMSS exhibitor for workflow and workflow tech-related content. We are finally seeing a remarkable search in workflow tech, such as workflow engines and business process management (BPM) highlighted defusing into healthcare and health IT. So, for this years HIMSS16 conference I sliced-and-diced that original series and white papers and am tweeting those bits during this years HIMSS16 conference. (Skip the “Table of Contents” and go directly to original 2004 material. Skip both the TOC and 2004 contents and go to HIMSS16 commentary.)

tepr-first-page

(also see the 2005 HIMSS05 paper EHR Workflow Management Systems in Ambulatory Care)

EHR Workflow Management Systems: Essentials, History, Healthcare

Charles Webster, MD, MSIE, MSIS

Abstract

Workflow management system technology promises critically important increases in electronic health record (EHR) usability and productivity. This paper describes the characteristics of electronic health record (EHR) workflow management systems (WfMSs): the difference between workflow management and mere workflow, the workflow reference model, the central role of the process definition, various frameworks within which to understand workflow, a productivity survey, the importance of workflow management to EHR usability, and future research and development directions.

Keywords

Workflow management systems, electronic health records.

Introduction

Electronic health record systems are evolving from patient documentation systems into tools for physicians to accomplish their many tasks and to manage others with whom they work in close conjunction: to document, to direct, and to delegate. EHRs used in this way must have customizable workflow—to specialty content, to local clinical and administrative processes, and to user preferences. If an EHR can be instructed (that is, customized) in what to do—automatically— based on who, what, why, when, where, and how, the EHR is not just a patient documentation system, it is an EHR workflow management system.

Throughout this article I will rely on a series of frameworks to present the components, behaviors, and advantages of EHR workflow management systems. These different frameworks are not mutually exclusive (occasionally making the same point in different terminology), however, used together, they provide a broad description of EHR workflow management systems components, behaviors, and advantages (over non-workflow management system EHRs).




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Today, “workflow management systems” has been superseded by “Business Process Management” systems (BPM). Though you will notice I do mention Business Process Management in this 2004 paper. You may also be interested in my more recent BPM-based Population Health Management & Care Coordination: Workflow, Usability, Safety & Interoperability Perspectives.

Take me to the next blog post in this series! The Critical Difference Between Workflow Management Versus Mere Workflow: Process-Aware HIT.


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